How Soon Do Patients Return to Activities Following Hip Fracture Surgery?
According to the American Academy of Orthopaedic Surgeons, more than 300,000 people in the US sustain a hip fracture annually, the majority of which occur in patients age 65 or older who are injured in household or community falls. The mortality rate within the first year after hip fracture is 20%
One of the unknowns associated with surgery for a hip fracture is how soon patients can return to their pre-facture level of function, specifically in regard to driving and mobility. An article published in the January issue of the Journal of the American Academy of Orthopaedic Surgeons provides some clarity on the recovery process: Utilizing data from the National Health and Aging Trends Study, the study authors found that patients can expect to regain full functionality within 2 to 3 years after hip fracture surgery.
The study also looked at the long-term psychosocial limitations of patients compared with peer groups and concluded that socialization may aid in recovery.
The National Health and Aging Trends Study is a large longitudinal study on aging. To analyze trends after a hip fracture, the study authors identified patients aged 65 and older who sustained a hip fracture between 2011 and 2017 and who had been driving and leaving the house regularly at the time of the fracture. These data were compared with a national, aged-matched control group with similar demographics and comorbidities.
“We wanted to take a closer look at outcomes including mobility, driving frequency, depression and the ability to participate in activities outside the home, such as shopping, working and volunteering, because these are all important factors in maintaining ones’ independence and returning to normalcy following a hip fracture,” said lead author Timothy Bhattacharyya, MD, an orthopaedic surgeon who is head of clinical orthopaedic research at the National Institute of Arthritis and Musculoskeletal and Skin Diseases in Bethesda, Maryland.
The study found that 1 year after the fracture, hip fracture patients were less likely to drive than patients in the control group (76% vs 95%), less likely to leave the house (86% vs 99%), less likely to work and volunteer (17% vs 44%) and more likely to feel depressed on most days (20% vs 10%). Hip fracture patients were also more likely to report being kept from their favorite activity due to their health for up to 2 years after the fracture.
The long-term prognosis for patients demonstrates measurable gains in function and well-being, as there was no statistically significant difference observed in driving frequency, leaving the house regularly or working/volunteering between subjects 2 to 3 years after fracture.
Dr. Bhattacharyya points to the important role large social networks play in recovery and encourages patients to push themselves to interact with friends and family. The study found that patients with large social networks were more likely to work or volunteer compared with those with small social networks (30% vs 12%). Patients with large social networks also tended to have fewer comorbidities.
“There’s a natural tendency to not want to share your burden with others; however, you really have to do the opposite to avoid isolation,” Dr. Bhattacharyya said. “With a greater understanding of how socialization aids recovery, I now proactively encourage my patients to reach out to their friends and family to interact. Given the pandemic, patients can participate in activities with a few select people and prioritize online social interaction with larger groups.”
Swayambunathan J, Dasgupta A, Bhattacharyya T. The pronounced impact of hip fractures on psychosocial well-being. J Am Acad Orthop Surg . 2021 Jan 1;29(1):e22-e30. doi: 10.5435/JAAOS-D-19-00530.